Massage.
MuscleForearm & handsuperficialBeyond Cert IVDraft

Pronator teresMusculus pronator teres

Short, rounded muscle crossing the front of the upper forearm that turns the palm down (pronation) and helps bend the elbow.

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LatinMusculus pronator teres
Origin
  • Humeral head: medial epicondyle of the humerus (common flexor tendon) and the medial supracondylar ridge just above it
  • Ulnar head: medial side of the coronoid process of the ulna
Insertion
  • Rough area at the middle of the lateral surface of the shaft of the radius
Action
  • Pronates the forearm (turns the palm to face down)
  • Assists elbow flexion, mainly against strong resistance
NerveMedian nerve (C6–C7)
NameLatin pronare, 'to bend forward', and teres, 'round and smooth' — the rounded muscle that turns the palm down.

Palpation

  1. Client supine with the forearm supported palm up and the elbow slightly bent.
  2. Find the medial epicondyle, then slide your fingers diagonally down and across the front of the forearm towards the middle of the radius.
  3. Feel a short, rounded band that forms the inner (medial) border of the cubital fossa, the hollow at the front of the elbow.
  4. Resist the client as they turn the palm down from a palm-up position; the belly firms under your fingers.

Landmarks: Medial epicondyle of humerus

Pronator teres is the most lateral of the muscles that share the common flexor tendon at the Medial epicondyle of humerus. It runs diagonally across the front of the elbow, so it is the first flexor-side muscle you meet when working from the cubital fossa towards the radius. Clients who do a lot of screwdriver, racquet or typing work commonly report tenderness here. Stripping along its short diagonal line is a useful way to separate it from the wrist flexors below it.

Pronator teres is the main antagonist of Supinator and Biceps brachii. The median nerve passes between its two heads. If a client reports tingling or numbness into the thumb and first two fingers during pressure here, ease off and suggest they see a health professional.

Sources differ slightly on root levels: Wikipedia gives C6–C7, while Gray’s (1918) says the supply comes “primarily from the sixth cervical nerve”.

Techniques

  • Petrissage — Kneading strokes that compress, lift and squeeze the muscle away from the bone, working the tissue between the hands.
  • Circular friction — Small circles made with the finger or thumb pads that move the skin over the deeper tissue without sliding, to work a specific spot.
  • Stripping — A slow, deep, narrow glide along the length of a single muscle with the thumb, knuckle or elbow, pausing over tight bands on the way.
  • Trigger point pressure release — Sustained thumb or finger pressure on a tender spot within a taut band of muscle, held until the client reports the discomfort easing, then slowly released.
  • Passive stretching — The therapist gently moves a relaxed limb to lengthen a muscle to a point of mild stretch and holds it there, with no effort from the client.

Works with

  • Flexor carpi radialis — Superficial forearm muscle that runs from the medial epicondyle to the index and middle finger metacarpals, bending the wrist and tilting it towards the thumb.
  • Brachioradialis — Long, superficial muscle on the thumb side of the forearm that flexes the elbow, most strongly with the thumb pointing up.

Opposes

  • Supinator — Deep, curved muscle that wraps around the top of the radius and turns the palm up (supination) in any elbow position.
  • Biceps brachii — Two-headed muscle on the front of the upper arm that bends the elbow and turns the palm up.

Sources

  1. Wikipedia: Pronator teres muscle
  2. Gray's Anatomy of the Human Body (1918), Myology 7e: The Muscles and Fasciae of the Forearm (Public domain. Used for actions and nerve root levels.)